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Claims  |
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I claim:
1. For use in a system for noninvasively determining the intra-arterial
blood pressure of a patient, a tissue contact stress sensing apparatus
comprising:
a wafer having a continuous diaphragm for placing against a patient's
tissue which covers an underlying artery, said diaphragm adapted to be
deformed in response to stress in said tissue caused by the intra-arterial
blood pressure of said artery,
semiconductor assembly means placed in close proximity to and spaced apart
from said continuous diaphragm for directly,
irradiating said diaphragm with electromagnetic radiation,
receiving a portion of said electromagnetic radiation reflected from said
continuous diaphragm, and
whereby the quantity of electromagnetic radiation received by said
semiconductor assembly means is a function of the displacement of said
continuous diaphragm in response to said tissue stress caused by said
intra-arterial blood pressure of said artery.
2. The tissue contact stress sensing apparatus of claim 1 wherein said
diaphragm is comprised of silicon.
3. The tissue contact stress sensing apparatus of claim 2, wherein said
diaphragm is comprised of single crystal silicon.
4. The tissue contact stress sensing apparatus of claim 2, wherein said
wafer is comprised of silicon and has a longitudinal trough therein and,
wherein the bottom of said trough forms one side of said diaphragm.
5. The tissue contact stress sensing apparatus of claim 4, wherein said
longitudinal trough has a cross-sectional profile generally resembling a
tetragonal-pyramidal geometry.
6. The tissue contact stress sensing apparatus of claim 4, wherein said
trough has a generally planar bottom.
7. The tissue contact stress sensing apparatus of claim 1, wherein said
wafer has a longitudinal trough therein and, wherein the bottom of said
trough forms one side of said diaphragm, and wherein said trough bottom is
coated with a reflective material for reflecting the electromagnetic
radiation irradiated by said semiconductor assembly means.
8. The tissue contact stress sensing apparatus of claim 7, wherein said
trough bottom is generally 6.5.times.10.sup.-6 meters thick.
9. The tissue contact stress sensing apparatus of claim 7, wherein said
trough bottom is coated with metal.
10. The tissue contact stress sensing apparatus of claim 9, wherein said
metal is selected from the group consisting of gold or aluminum.
11. The tissue contact stress sensing apparatus of claim 9, wherein said
metal coating is generally 600 angstroms thick.
12. The tissue contact stress sensing apparatus of claim 1, wherein said
diaphragm has an effective stiffness which is sufficient to prevent
significant distortion of the stress information contained within the
received electromagnetic radiation.
13. The tissue contact stress sensing apparatus of claim 1, wherein said
continuous diaphragm has a strain rate of generally 0.24 micro-inch/mmHg.
14. The tissue contact stress sensing apparatus of claim 1, wherein said
diaphragm has two opposing longitudinal sides spaced generally 0.020
inches apart.
15. The tissue contact stress sensing apparatus of claim 1, wherein said
wafer has a generally rectangular face for placing against said tissue
overlying said artery, said face having a first and second set of opposing
parallel sides, wherein said first set of opposing sides of said
rectangular face are generally 0.577 inches apart, and wherein said
diaphragm is bounded by at least two generally parallel sides spaced
generally 0.425 inches apart.
16. The tissue contact stress sensing apparatus of claim 15, wherein said
second set of opposing parallel sides of said face are generally 0.200
inches apart.
17. The tissue contact stress sensing apparatus of claim 1 further
including a spacer element disposed between said wafer and said
semiconductor assembly means and wherein said spacer element, diaphragm,
wafer and semiconductor assembly means all have a substantially similar
thermal expansion coefficient for minimizing thermally induced drift and
offset errors.
18. The tissue contact stress sensing apparatus of claim 17, wherein said
spacing element is comprised of silicon nitride.
19. The tissue contact stress sensing apparatus of claim 1, wherein said
semiconductor assembly means is comprised of a plurality of emitters for
irradiating said diaphragm with electromagnetic radiation, and a plurality
of detectors each having an output, each detector receiving a portion of
said electromagnetic radiation and transducing said received radiation
into a respectively associated electronic current output signal.
20. The tissue contact stress sensing apparatus of claim 19, wherein said
continuous diaphragm is generally planar having a rectangular boundary,
said boundary having an opposing pair of long sides and an opposing pair
of short sides.
21. The tissue contact stress sensing apparatus of claim 20, wherein said
plurality of emitters are arranged generally in a row which is generally
parallel to and spaced apart from one of said long sides of said
diaphragm, and wherein said detectors are arranged generally in a row
separate from said row of emitters, and generally parallel to and spaced
apart from one of said long sides of said diaphragm.
22. The tissue contact stress sensing apparatus of claim 21, wherein said
emitters are generally equally spaced apart from one another and said
detectors are generally equally spaced apart from one another, and wherein
said row of emitters is juxtaposed to said row of detectors such that any
two adjacent detectors in said row of detectors lie equidistant from at
least one common emitter in said row of emitters.
23. The tissue contact stress sensing apparatus of claim 19, wherein each
emitter in said plurality of emitters irradiates electromagnetic radiation
in a beam field which when projected onto said diaphragm, overlaps the
projected beam field of its closest adjacent neighbors.
24. The tissue contact stress sensing apparatus of claim 19, wherein said
electromagnetic radiation is selected from the group consisting of
visible, infrared and ultraviolet light.
25. The tissue contact stress sensing apparatus of claim 19, further
comprising converter means, coupled to the outputs of said detectors, for
converting said electric current signal output by each detector into an
electric voltage signal.
26. The tissue contact stress sensing apparatus of claim 25, further
comprising multiplexing means and central processing means, said
multiplexing means coupled to said converter means for selecting one of
said converted electronic signals and transferring said signal to said
central processing means for analysis.
27. The tissue contact stress sensing apparatus of claim 1, wherein said
semiconductor assembly means includes a portion for irradiating
electromagnetic radiation onto and detecting electromagnetic radiation
reflected from a reference surface, said reference surface spaced apart
from said diaphragm.
28. The tissue contact stress sensing apparatus of claim 27, wherein said
semiconductor assembly means and said portion of said semiconductor
assembly means are fabricated from substantially the same materials and
reside in close proximity to each other.
29. The tissue contact stress sensing apparatus of claim 28, wherein said
electromagnetic radiation is selected from the group consisting of
visible, infrared and ultraviolet light.
30. For use in a system for noninvasively determining the intra-arterial
blood pressure of a patient, a tissue contact stress sensor for generating
a tissue contact stress signal indicative of said intra-arterial blood
pressure and a correction signal for compensating for errors in said
tissue contact stress signal caused by temperature drift and aging of said
sensor, said system comprising:
a wafer having a continuous diaphragm and a nonresponsive portion, said
continuous diaphragm for placing against a patient's tissue which covers
an underlying artery, said diaphragm adapted to be deformed in response to
said intra-arterial blood pressure of said artery,
semiconductor assembly means spaced apart from and placed in close
proximity to said continuous diaphragm for directly,
irradiating said diaphragm with electromagnetic radiation,
receiving a portion of said electromagnetic radiation reflected from said
continuous diaphragm,
converting said received radiation into a tissue contact stress signal
which represents blood pressure data whereby the quantity of
electromagnetic radiation which is received by said semiconductor assembly
means is a function of the displacement experienced by said continuous
diaphragm in response to said intra-arterial blood pressure of said
artery,
spacing structure coupled to said nonresponsive portion of said wafer and
said semiconductor assembly means, said spacing structure fixing said
separation between said semiconductor assembly means and said wafer,
a portion of said semiconductor assembly means, spaced apart from and
placed in close proximity to said nonresponsive portion of said wafer for
directly,
irradiating said nonresponsive portion of said wafer with electromagnetic
radiation,
receiving a portion of said electromagnetic radiation reflected from said
nonresponsive portion of said wafer,
converting said received radiation into a correction signal which
represents reference data which is indicative of at least one reference
factor, and
whereby any change in the radiation received by said portion of said
semiconductor assembly means is attributed to at least one of said
reference factors and whereby said correction signal is combined with said
tissue contact stress signal in a manner which minimizes the dependence of
said blood pressure data on at least one of said reference factors.
31. The tissue contact stress sensor of claim 30, wherein said reference
factors include temperature and aging of said wafer, semiconductor
assembly means and spacing structure.
32. The tissue contact stress sensor of claim 30, wherein said
semiconductor assembly means and said portion of said semiconductor
assembly means are fabricated from substantially the same materials and at
substantially the same time and said materials reside in close proximity
to each other.
33. The tissue contact stress sensor of claim 30, wherein said diaphragm is
comprised of single crystal silicon.
34. The tissue contact stress sensor of claim 33, wherein said spacing
structure is comprised of silicon nitride.
35. The tissue contact stress sensor of claim 30, wherein said
electromagnetic radiation is selected from the group consisting of
visible, infrared, and ultraviolet light.
36. The tissue contact stress sensor of claim 30, wherein said diaphragm is
comprised of a silicon base having a longitudinal trough therein.
37. The tissue contact stress sensor of claim 36, wherein said trough has a
generally planar bottom.
38. The tissue contact stress sensor of claim 37, wherein said trough
bottom is generally 6.5.times.10.sup.-6 meters thick.
39. A method for correcting errors in the output signal of a tissue contact
stress sensor, said errors caused by the effects of aging and
environmental factors on said sensor, said tissue contact stress sensor of
the type having an element for placing against a patient's tissue covering
an artery of interest, said element responsive to tissue stress,
comprising the steps of:
constructing a tissue contact stress sensor and a reference sensor from
substantially identical materials at substantially the same time,
adapting said tissue contact stress sensor to be responsive to said
element,
adapting said reference sensor to be responsive to a fixed reference source
which does not vary with said tissue contact stress measured by said
tissue contact stress sensor, whereby an output signal of said reference
sensor only changes as a function of said reference sensor aging,
temperature and environmental factors,
adapting said tissue contact stress sensor and said reference sensor to
share the same environment so as to be equally influenced by aging and
environmental factors, and
combining the output signals generated by said tissue contact stress sensor
and said reference sensor in a way which removes said influence of aging
and environmental factors from said output of said tissue contact stress
sensor.
40. For use in a system for noninvasively determining the intra-arterial
blood pressure of a patient, a miniaturized tissue contact stress sensing
apparatus comprising:
a silicon wafer having a nonresponsive portion and a continuous silicon
diaphragm portion, said continuous silicon diaphragm portion for placing
against a patient's tissue which covers an underlying artery, said
diaphragm adapted to be responsive to stress in said tissue caused by
blood pressure pulsations in said underlying artery,
integrated circuit means placed in close proximity to and spaced apart from
said continuous diaphragm for directly,
irradiating said diaphragm with electromagnetic radiation,
receiving a portion of said electromagnetic radiation reflected from said
continuous diaphragm, and
whereby the quantity of electromagnetic radiation received by said
integrated circuit means is a function of the tissue stress sensed by said
continuous diaphragm, said tissue stress resulting from blood pressure
pulsations in said underlying artery.
41. The tissue contact stress sensing apparatus of claim 40, wherein said
diaphragm is comprised of single crystal silicon.
42. The tissue contact stress sensing apparatus of claim 40, wherein said
wafer has a longitudinal trough therein and wherein the bottom of said
trough forms one side of said diaphragm and wherein said longitudinal
trough has a cross-sectional profile generally resembling a
tetragonal-pyramidal geometry.
43. The tissue contact stress sensing apparatus of claim 42, wherein said
trough has a generally planar bottom and wherein said trough bottom is
coated with a material for reflecting the electromagnetic radiation
irradiated by said integrated circuit means.
44. The tissue contact stress sensing apparatus of claim 43, wherein said
trough bottom is generally 6.5.times.10.sup.-6 meters thick.
45. The tissue contact stress sensing apparatus of claim 43, wherein said
trough bottom is coated with metal and wherein said metal is selected from
the group consisting of gold or aluminum and wherein said metal coating is
generally 600 angstroms thick.
46. The tissue contact stress sensing apparatus of claim 40, wherein said
diaphragm has an effective stiffness of generally fifty times greater than
that typical of said tissue over laying said artery.
47. The tissue contact stress sensing apparatus of claim 40, wherein said
continuous diaphragm has a strain rate of generally 0.24 micro-inch/mmHg.
48. The tissue contact stress sensing apparatus of claim 40, wherein said
diaphragm has two opposing longitudinal sides spaced generally 0.020
inches apart.
49. The tissue contact stress sensing apparatus of claim 40, wherein said
wafer has a generally rectangular face for placing against said tissue
overlying said artery, said face having a first and second set of opposing
parallel sides, wherein said first set of opposing sides of said
rectangular face are generally 0.577 inches apart, and wherein said
diaphragm is bounded by at least two generally parallel sides spaced
generally 0.425 inches apart and wherein said second set of opposing
parallel sides of said face are generally 0.200 inches apart.
50. The tissue contact stress sensing apparatus of claim 40, further
including a spacing element disposed between said continuous diaphragm and
said integrated circuit means for providing alignment and positioning of
said integrated circuit means in relation to said diaphragm and wherein
said spacing element has a thermal expansion coefficient substantially
similar to that of said continuous diaphragm and wherein said spacing
element is comprised of silicon nitride.
51. The tissue contact stress sensing apparatus of claim 40, wherein said
integrated circuit means is comprised of a plurality of emitters for
irradiating said diaphragm with electromagnetic radiation, and a plurality
of detectors each having an output, each detector receiving a portion of
said electromagnetic radiation and transducing said received radiation
into a respectively associated electric current output signal.
52. The tissue contact stress sensing apparatus of claim 51, wherein said
continuous diaphragm is generally planar having a rectangular boundary,
said boundary having an opposing pair of long sides and an opposing pair
of short sides and wherein said plurality of emitters are arranged
generally in a row which is generally parallel to and spaced apart from
one of said long sides of said diaphragm, and wherein said detectors are
arranged generally in a row separate from said row of emitters, and
generally parallel to and spaced apart from one of said long sides of said
diaphragm.
53. The tissue contact stress sensing apparatus of claim 52, wherein said
emitters are generally equally spaced apart and said detectors are
generally equally spaced apart, and wherein said row of emitters is
juxtaposed to said row of detectors such that any two adjacent detectors
in said row of detectors lie equidistant from at least one common emitter
in said row of emitters.
54. The tissue contact stress sensing apparatus of claim 51, wherein each
emitter in said plurality of emitters irradiates electromagnetic radiation
in a beam field which when projected onto said diaphragm, overlaps the
projected beam field of its closest adjacent neighbors.
55. The tissue contact stress sensing apparatus of claim 51, wherein each
emitter radiates electromagnetic energy which follows a Lambertian pattern
about an axis normal to an emitting surface of said emitter and wherein
said electromagnetic radiation is selected from the group consisting of
visible, infrared and ultraviolet light.
56. The tissue contact stress sensing apparatus of claim 51, further
comprising converter means coupled to the outputs of said detectors for
converting said electric current signal output by each detector into and
electric voltage signal and further comprising multiplexing means and
central processing means said multiplexing means coupled to said converter
means for selecting one of said converted electronic signals and
transferring said signal to said central processing means for processing.
57. The tissue contact stress sensing apparatus of claim 40, wherein said
integrated circuit means further includes a referencing portion for
irradiating electromagnetic radiation onto and detecting electromagnetic
radiation reflected from a surface of said nonresponsive portion of said
silicon wafer, said nonresponsive wafer surface spaced apart from said
diaphragm and wherein said integrated circuit means and said referencing
portion of said integrated circuit means are fabricated from substantially
the same materials and reside in close proximity to each other and wherein
said electromagnetic radiation is selected from the group consisting of
visible, infrared and ultraviolet light. |
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Claims  |
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Description  |
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TECHNICAL FIELD
The present invention generally relates to a pressure measurement system,
and more particularly relates to a system for noninvasively determining
the blood pressure of a patient by detecting the surface stress of tissue
above an arterial vessel.
BACKGROUND OF THE INVENTION
Systems for determining the intra-arterial blood pressure of a patient can
be subdivided into two main groups-those which invade the arterial wall to
directly access blood pressure and those which use non invasive
techniques. For a long period of time, the most accurate blood pressure
measurements were achievable only by use of invasive methods. One such
common method involved use of a fluid filled catheter inserted into the
patient's artery.
While invasive methods provide for accurate blood pressure measurements,
the risk of infection and potential for complications, in many cases,
outweigh the advantages of using invasive methods. Because of the risk of
complication associated with invasive methods, a noninvasive method, known
as the Korotkoff method is widely used. The Korotkoff method is known as
an auscultatory method because it uses the characteristic sound made as
the blood flows through the artery to denote the high and low blood
pressure points. Although the Korotkoff method is noninvasive, it only
provides a measurement of the highest blood pressure (systolic) and the
lowest blood pressure (diastolic) along the continuous pressure wave form.
While systolic and diastolic pressure are often sufficient for accurate
diagnosis, there are many applications in which it is desirable to use the
entire curve of the blood pressure wave form. In these applications, the
Korotkoff method simply is incapable of providing satisfactory
information. In addition to this limitation of the Korotkoff method, it
necessitates the temporary occlusion of the artery in which blood pressure
is being monitored. While arterial occlusion is not prohibited in many
applications, there are occasions where the patient's blood pressure must
be monitored continuously (such as when undergoing surgery) and
accordingly, prohibiting blood flow, even on a temporary basis, is
undesirable or unacceptable. Other problems associated with the Korotkoff
method include the fact that the cuff must be properly sized with respect
to the patient and the detrimental affects of respiration and acoustic
noise on overall measurement accuracy.
Because of the above mentioned risks involved with invasive blood pressure
measurement, and the shortcomings of the Korotkoff method, extensive
investigation has been conducted in the area of continuous, noninvasive
blood pressure monitoring and recording methods. Many of these noninvasive
techniques make use of tonometric principles which center around the fact
that as blood flows through the arterial vessel, forces are transmitted
through the artery wall and through the surrounding arterial tissue and
are accessible for monitoring. Because the tonometric method of
determining blood pressure is noninvasive, it is used without the risks
associated with invasive techniques. Furthermore, since it does not suffer
from the limitations of the auscultatory method, it has the capability of
reproducing the entire blood pressure wave form, as opposed to the limited
systolic and diastolic pressure points provided by the Korotkoff method.
In several of the prior art arterial tonometers, a row of individual
transducer elements, such as strain gauges or the like, are placed in
direct contact with the tissue which overlays an arterial vessel from
which blood pressure is to be measured. As the blood pressure within the
arterial vessel increases and decreases the vessel wall expands and
contracts thereby transmitting forces through the overlying tissue and
onto the row of transducer elements. Although the individual elements are
dimensionally sized so that several are required to cover the entire
diameter of the underlying arterial vessel, their discrete character
prevents reconstructing a true continuous contour of the tissue stresses
which occur across the entire row of elements.
It has also been found that many prior art tonometry sensors are
cumbersome, difficult to administer and uncomfortable to wear for any long
period of time.
Thus, it is desirable to provide a noninvasive tonometry system for
determining the blood pressure in an arterial vessel by measuring the
stress of the tissue overlaying the arterial vessel.
Still further, it is desirable to have a system which is capable of
accurately reconstructing a continuous stress contour across the diameter
of an artery of interest.
It is also desirable to have a system which automatically compensates for
errors introduced into the tissue stress signal which result from
temperature, aging or other factors which influence the tissue stress
sensor.
Additionally, it is desirable to have a miniaturized sensor which can be
easily administered and comfortably worn for long periods of time.
SUMMARY OF THE INVENTION
In light of the foregoing objects, the present invention provides a tissue
contact stress sensor for use in a system for noninvasively determining
the intra-arterial blood pressure of a patient. The tissue contact stress
sensor comprises a continuous diaphragm for placing against a patient's
tissue which covers an underlying artery. The diaphragm is adapted to be
deformed in response to stresses in the tissue created by the arterial
blood pressure within the underlying artery. A semiconductor assembly is
placed in close proximity to and spaced apart from the continuous
diaphragm. The semiconductor assembly irradiates the diaphragm with
electromagnetic radiation and receives a portion of the electromagnetic
radiation which is reflected from the continuous diaphragm. The quantity
of electromagnetic radiation which is received by the semiconductor
assembly is a function of the stress experienced by the tissue overlaying
the artery. Under controlled conditions, intra-arterial blood pressure can
be determined by measuring the stress of the tissue overlaying the artery.
Because the semiconductor assembly performs both the irradiating and
receiving function, it allows the tissue contact stress sensor to be
miniaturized and allows the semiconductor assembly to be placed very close
to the continuous diaphragm. In a preferred embodiment, the diaphragm is
comprised of silicon and includes a silicon base having a longitudinal
trough therein. The cross-sectional profile of the trough generally
resembles a tetragonal-pyramidal geometry. The trough bottom is generally
planar and is preferably coated with a material for reflecting the
electromagnetic radiation irradiated by the semiconductor assembly.
The sensing apparatus preferably includes a spacing element disposed
between the diaphragm and the semiconductor assembly for providing fixed
alignment and positioning of the semiconductor assembly in relation to the
diaphragm. Preferably the spacing element has a thermal expansion
coefficient substantially similar to the continuous diaphragm. This
arrangement ensures that thermal stresses will be minimized between the
two elements.
In a preferred embodiment, the semiconductor assembly is comprised of a
plurality of emitters for irradiating the diaphragm with electromagnetic
radiation and a plurality of detectors each having an output and each
detector receiving a portion of the electromagnetic radiation which is
reflected from the diaphragm and transducing the received radiation into a
respectively associated electronic output signal. The continuous diaphragm
is preferably generally planar having a rectangular boundary which has an
opposing pair of long sides and an opposing pair of short sides. The
plurality of emitters are preferably arranged generally in a row which is
generally parallel to and spaced apart from one of the long sides of the
diaphragm and the detectors are preferably arranged generally in a row
spaced from the row of emitters and generally parallel to and spaced apart
from one of the long sides of the diaphragm. Each emitter in the row of
emitters is generally equally spaced apart from its adjacent neighbors and
each detector in the row of detectors is generally equally spaced apart
from its adjacent neighbors. The row of emitters is juxtaposed to the row
of detectors such that any two adjacent detectors in the row of detectors
lie equidistant from at least one common emitter in the row of emitters.
Each emitter preferably irradiates electromagnetic radiation in a beam
field which when projected onto the diaphragm overlaps the projected beam
field of its closest adjacent neighbors. Preferably, the electromagnetic
radiation is selected from the group consisting of visible, infrared and
ultraviolet light.
A portion of the semiconductor assembly (referencing portion) is used for
irradiating electromagnetic radiation onto and detecting electromagnetic
radiation reflected from a reference surface which does not move (i.e. is
nonresponsive) with respect to tissue stress applied to the diaphragm. The
reference surface is spaced apart from the diaphragm.
A current to voltage converter is respectively associated with the output
of each detector for converting the current signal output by each
respective detector to a voltage signal. A multiplexer is connected to the
output of the converters for multiplexing their output to a central
processing means wherein the data contained in the output signal of the
converters is conditioned and processed.
Still further, the present invention provides a tissue contact stress
sensor which generates a tissue contact stress signal indicative of the
intra-arterial blood pressure of an arterial vessel and a correction
signal for compensating for errors in the tissue contact stress signal
caused by temperature drift and aging of the sensor. The system comprises
a continuous diaphragm for placing against a patient's tissue which covers
an underlying artery. The diaphragm is adapted to deform in response to
stresses in the tissue overlaying the artery.
A semiconductor assembly is spaced apart from and placed in close proximity
to the continuous diaphragm for directly irradiating the diaphragm with
electromagnetic radiation and receiving a portion of the electromagnetic
radiation irradiating from the continuous diaphragm. The semiconductor
assembly converts the received radiation into a tissue contact stress
signal (first signal) which represents blood pressure data whereby the
quantity of electromagnetic radiation which is received by the
semiconductor assembly is a function of the intra-arterial blood pressure.
A spacing structure is coupled to the diaphragm and the semiconductor
assembly thereby fixing the separation between the semiconductor assembly
and the diaphragm. A referencing portion of the semiconductor assembly is
spaced apart from and placed in close proximity to a wafer for directly
irradiating a nonresponsive, reflective portion of the underside of the
wafer with electromagnetic radiation and receiving a portion of the
electromagnetic radiation reflected from the nonresponsive portion of the
wafer. The referencing portion of the semiconductor assembly converts the
received radiation into a second signal which represents reference data
which is indicative of at least one reference factor whereby any change in
the radiation received by the referencing portion of the semiconductor
assembly is attributed to a change in at least one reference factor. The
second signal is combined with the first signal in a manner which
minimizes the dependence of the tissue contact stress data on the
reference factors. The reference factors preferably include temperature of
the sensor and effects due to sensor aging. The semiconductor assembly and
the referencing portion of the semiconductor assembly are preferably
fabricated from substantially the same materials and at substantially the
same time and reside in substantially the same environment. This ensures
that they track each other's age, temperature and other commonly shared
environmental factors.
Still further the present invention provides a method for correcting errors
in the output signal of a tissue contact stress sensor which are caused by
the effects of aging and environmental factors on the sensor. The tissue
contact stress sensor is of the type having an element for transducing
blood pressure of a patient into a tissue stress signal. This method
includes constructing a tissue contact stress sensor and a reference
sensor from substantially identical materials at substantially the same
time. The tissue contact stress sensor is adapted to be responsive to the
tissue stress in the region of a superficial vessel and the reference
sensor is adapted to be responsive to a fixed structural reference which
does not vary with the tissue stress measured by the tissue contact stress
sensor. The tissue contact stress sensor and a reference sensor are
adapted to share the same environment so as to be equally influenced by
aging, temperature and other environmental factors. Signals generated by
the tissue contact stress sensor and a reference sensor are combined such
that the errors caused by the effects of aging, temperature and other
environmental factors are minimized.
Other advantages and meritorious features of the presentation will become
more fully understood from the following description of the preferred
embodiments, the appended claims and the drawings, a brief description of
which follows.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a plan view of the system of the present invention as applied to
the wrist of a patient.
FIG. 2 is a cross-sectional view of the system of the present invention
taken substantially along lines 2--2 of FIG. 1.
FIG. 3 is an amplified view of the system of the present invention taken
substantially within encircled portion 3 of FIG. 2.
FIG. 4 is a cross-sectional view of the tissue contact stress sensor of the
present invention taken substantially along lines 4--4 of FIG. 3.
FIG. 5 is a cross-sectional view of the tissue contact stress sensor of the
present invention taken substantially along lines 5--5 of FIG. 4.
FIG. 6 is a partially exploded view of the tissue contact stress sensor of
the present invention.
FIGS. 7a and 7b are diagrammatic views of the emitter and detector portions
of the semiconductor assembly of the present ivention.
FIG. 8 is an electronic block diagram of the tissue contact stress sensor
of the present invention.
FIG. 9 is a detailed schematic of the block diagram of FIG. 8.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
Now referring to the drawing of FIG. 1, arterial tonometer 10 is placed
about wrist 12 of a patient for determining the patient's blood pressure.
Arterial tonometer 10 measures the patient's intra-arterial blood pressure
noninvasively by sensing the time varying surface tissue contact stresses
in regions immediately over and in the vicinity of the artery of interest.
In general, the artery to be measured must be superficial and overlaying
relatively rigid structures. The arteries most commonly used are the
radial artery in the wrist, the superficial temporal artery in the
forehead the and the dorsalis pedis artery in the foot. For purposes of
this disclosure, the radial artery in the wrist will be used as the main
artery of discussion; however, the system of the present invention is
equally applicable to any superficial artery which overlays a relatively
rigid structure.
Now referring to the drawing of FIG. 2, arterial tonometer 10 comprises
clamp body 14, rack 16, push arm 18 and sensor 20. Rack 16 is driven by
motor 13 through pinion 11. Clamp 14 can take on any number of
configurations and is shown here in a generic form. Motor 13 is adapted to
rotate thereby rotating pinion 11 and moving rack 16. Any movement of rack
16 moves sensor 20 via push arm 18. When motor 13 is rotated in the
appropriate direction, sensor 20 is forced against tissue 24 which
overlays radial artery 26. The displacement caused by sensor 20 is
adjusted to a level which properly applanates radial artery 26 without
causing artery 26 to occlude.
An important element of the present invention is sensor 20 and its
surrounding structure. Because sensor 20 is used to compress or applanate
radial artery 26 during blood pressure measurement as well as measure the
contact stress in tissue 24, the geometry of sensor 20 and its surrounding
structure are vital to the proper conduction of stresses from radial
artery 26 to tissue surface 28. A detailed discussion of sensor 20 and its
associated structure now follows.
Now referring to the drawing of FIG. 3, sensor 20 includes wafer 30 which
has a nonresponsive portion 32 and a responsive portion (diaphragm) 34.
Nonresponsive portion 32 serves mainly to support and press responsive
portion 34 upon tissue overlying radial artery 26. Under normal conditions
when sensor 20 is not being applied to tissue 24, radial artery 26 has a
generally rounded cross-section as depicted at 26'. As wafer 30 of sensor
20 is pressed upon tissue 24, radial artery 26' begins to applanate or
flatten along its top surface 36, causing responsive portion 34 of wafer
30 to deflect slightly inward 38. As the blood pressure within radial
artery 26 changes (i.e. pulsates), stress is created in tissue 24 which
disturbs the equilibrium between responsive portion 34 of wafer 30 and top
surface 28 of overlying tissue 24. This disturbance in equilibrium causes
movement between diaphragm 34 and surface 24. Such movement exists until a
new equilibrium is established. The ability of diaphragm 34 to move and
assume a unique displacement position for a given blood pressure within
radial artery 26 forms the fundamental mechanism whereby sensor 20 is able
to transduce the intra-arterial pressure of radial artery 26. The details
of sensor 20 will now be fully discussed.
Now referring to the drawing of FIG. 4, tissue contact stress sensor 20 is
comprised of sensor head 40 and sensor base portion 42. Sensor head 40
comprises the transducer portion of sensor 20 and sensor base portion 42
includes electronic circuitry and other mechanical support structure
necessary for properly operati | | |